These Philly Doctors Are Using Advanced Treatments to Help Breast Cancer Patients Thrive. Here’s How.

Breast cancer research has been undergoing rapid evolution in prevention, diagnosis, treatment and survivorship, enabling physicians to create personalized programs to help patients not only survive, but thrive. Advances in genetics and testing, radiation therapy and plastic surgery, for example, enable physicians to detect cancer early, offer targeted therapies to eradicate cancer, and preserve patients’ quality of life. With new technology and discoveries continually being made, it’s an exciting time in breast cancer research and treatment.

And, as a leading health care city, some of the most significant treatment developments are occurring right here in Philadelphia. So, to better understand how breast cancer treatment is changing the outlook for patients, we spoke to three physicians at the forefront of breast cancer care in Philly about the different ways the battle against breast cancer is being won.

Targeted Therapy 

Cancer cells are fueled by genes and proteins that control how they grow, divide and spread. As researchers learn more about the DNA changes and proteins that drive cancer, they are better able to design treatments that target these proteins. This is the foundation of precision medicine, according to breast cancer specialist Sandra Urtishak, MD, hematologist and oncologist at Main Line Health.

“Targeted treatments can attack specific breast cancer cells without harming normal cells,” says Urtishak. “They may be used in combination with traditional chemotherapy or immunotherapy, usually with fewer side effects.”

Obtaining genetic information allows physicians like Urtishak to treat patients with many types of breast cancer, including HER2-positive breast cancer, hormone receptor-positive breast cancer, triple negative breast cancer and patients with BRCA gene mutations.

Radiation Therapy

Successful cancer treatment eliminates as much of the cancer as possible while protecting healthy tissue. Recent advances in radiation therapy have made that effort much more feasible for many formerly difficult-to-treat cancers.

“Advanced radiotherapy allows radiation oncologists to treat a tumor from many directions with pinpoint accuracy and in only three to five sessions, compared with 20 to 40 with standard radiation therapy,” says Linna Li, MD, chief of radiation oncology for Main Line Health. “This type of precise treatment is called stereotactic body radiation therapy, or SBRT. It is often used for treating stage IV cancer that has spread to other parts of the body. When combined with immunotherapy, SBRT can effectively control the tumor target over 95 percent of the time, with little to no side effects. Recent research suggests that SBRT can even extend survival for patients with stage IV colon, breast, lung or prostate cancer. For some patients with limited stage IV disease, when combined with chemotherapy and immunotherapy, it may even cure their cancer. This is extremely exciting and why I love what I do.”

According to Li, advancements in radiation therapy have largely been in shaping and controlling the way the radiation gets to the tumor. One radiation therapy development includes the use of personalized 3D-printed skin molds of the patient to ensure that the radiation beams reach tumor cells near the skin. This technology is only available at Main Line Health and a limited number of other centers in the U.S. Other advancements allow radiation treatments using 4D image guidance, which captures a tumor’s precise location between breathing cycles. This allows physicians like Li to more quickly and safely eliminate the cancer while protecting the patient’s heart and lungs.

Oncoplastic Surgery

With greater survival rates, breast cancer surgeons today are focused on how treatment will impact the individual long-term. Breast cancer surgeons work in tandem with plastic surgeons to not only completely remove the cancer but also to do it in a way that helps women maintain their femininity and ultimately get back to who they were before cancer.

“We have broadened our surgical approaches to include expanded indications for breast conservation, skin- and nipple-sparing mastectomies and hidden-scar surgery,” says Lina Sizer, DO, FACS, Main Line Health breast surgeon. “These approaches preserve healthy tissue, minimize scarring, and lead to improved body image in our patients, which has a large impact on quality of life.  Our plastic surgeons are trained in the latest reconstructive techniques using the patient’s own tissue, which results in a breast that looks and feels more natural.”

The medical team involved in each patient’s care plans every aspect of the patient’s treatment together, Sizer says. This plan involves not only the current standard of care, but also the possibility for new clinical trials and other innovative approaches. This enables breast cancer specialists like Sizer to plan for each patient’s best outcome and a happy, healthy life in the years to come.